Immunity EAQ Hesi Quiz
The parents of an infant ask the nurse why their baby is scheduled to receive the intramuscular polio vaccine rather than the oral vaccine. What is the best response by the nurse? 1 "The American Academy of Pediatrics recommends the intramuscular vaccine because it is safer." 2 "The consensus is that either can be used because they produce the same results and are equally safe." 3 "The oral vaccine is more expensive, so the intramuscular vaccine is preferred unless it is contraindicated." 4 "The U.S. Centers for Disease Control and Prevention recommends the intramuscular vaccine unless the infant or a family member is immunocompromised."
1 "The American Academy of Pediatrics recommends the intramuscular vaccine because it is safer." The American Academy of Pediatrics and the Centers for Disease Control and Prevention are recommending the IM polio vaccine because of the danger of acquiring vaccine-associated polio paralysis with the oral vaccine. The two vaccines are not equally safe; the intramuscular one is safer. Cost is not the issue; safety is. The oral vaccine is less expensive. If the infant is immunocompromised, the health care provider will discuss with the parents whether the vaccine should be administered.
A preschool child is found to have chickenpox during the acute phase. The nurse tells the parents, "It's important not to expose your child to anyone undergoing certain types of prolonged medication therapy." What medication therapy puts a person at risk? 1 Anticonvulsant 2 Systemic steroid 3 Antihypertensive 4 Topical antibiotic
2 Systemic steroid Individuals who are taking steroids have lowered resistance and may become fatally ill if exposed to the varicella virus. Anticonvulsants and antihypertensives do not lower body resistance; therefore they do not increase susceptibility. Topical antibiotics do not affect body resistance because topical antibiotics do not have systemic effects.
A 5-year-old-child is undergoing chemotherapy. The mother tells the nurse that the child is not up to date on the required immunizations for school. What is the best response by the nurse? 1 "By this time your child has developed sufficient antibodies to provide immunity." 2 "Maintaining current immunizations is critical. Make sure the series is completed." 3 "This isn't the best time to finish the immunizations, because your child's immune system is suppressed." 4 "It's important to complete the immunizations because your child needs to be protected from childhood diseases that could be fatal."
Correct3 "This isn't the best time to finish the immunizations, because your child's immune system is suppressed." Chemotherapy compromises the immune system. The vaccines may be administered after the completion of the chemotherapy protocol, once the immune system has returned to its previous state. The child has not developed sufficient antibodies; booster immunizations are needed, but not at this time. Administering immunizations at this time could prove fatal.
A client newly diagnosed with scleroderma states, "Where did I get this from?" The nurse's best response is "Although no cause has been determined for scleroderma, it is thought to be the result of: 1 Autoimmunity." 2 Ocular motility." 3 Increased amino acid metabolism." 4 Defective sebaceous gland formation."
1 Autoimmunity. Scleroderma is an immunological disorder characterized by inflammatory, fibrotic, and degenerative changes. Ocular motility, increased amino acid metabolism, and defective sebaceous gland formation are not involved in the development of scleroderma Test-Taking Tip: Reread the question if the answers do not seem to make sense, because you may have missed words such as not or except in the statement.
The nurse explains to a client that a positive diagnosis for human immunodeficiency virus (HIV) infection is made based on: 1 Positive enzyme-linked immunosorbent assay (ELISA) and Western blot tests 2 Performance of high-risk sexual behaviors 3 Evidence of extreme weight loss and high fever 4 Identification of an associated opportunistic infection
1 Positive enzyme-linked immunosorbent assay (ELISA) and Western blot tests Positive ELISA and Western blot tests confirm the presence of HIV antibodies that occur in response to the presence of the human immunodeficiency virus. Performance of high-risk sexual behaviors places someone at risk but does not constitute a positive diagnosis. Evidence of extreme weight loss and high fever do not confirm the presence of HIV; these adaptations are related to many disorders, not just HIV infection. The diagnosis of just an opportunistic infection is not sufficient to confirm the diagnosis of HIV. An opportunistic infection (included in the Center for Disease Control surveillance case definition for acquired immunodeficiency syndrome [AIDS]) in the presence of HIV antibodies indicates that the individual has AIDS.
An infant is receiving the first diphtheria and tetanus toxoids and acellular pertussis vaccine (DTaP) at 2 months of age. What instructions should the nurse give the parents? 1 Give a baby aspirin if there is pain. 2 Call the clinic if marked drowsiness occurs. 3 Apply ice to the injection site if there is swelling. 4 Provide heat at the injection site if redness occurs
2 Call the clinic if marked drowsiness occurs. Altered level of consciousness and seizures are rare but serious complications of the pertussis vaccine. Aspirin should not be given to infants and children because it is associated with Reye syndrome, and the nurse is not legally allowed to prescribe medications anyway. Infants are sensitive to the application of ice. Heat will cause an extension of the inflammatory response and should be avoided.
A nurse in the pediatric clinic plans to administer a booster immunization for polio to a child. Which vaccine should the nurse administer? 1 Hib 2 IPV 3 OPV 4 DTaP
2 IPV The current polio vaccine is the inactivated polio vaccine (IPV; Salk vaccine) that is injectable. Hib is the Haemophilus influenzae type b vaccine. OPV is the oral polio vaccine (Sabin vaccine); it is no longer administered because it is related to vaccine-associated polio paralysis. However, it is used in the worldwide effort to eliminate the virus in countries where it is endemic. DTaP is the diphtheria, tetanus, and acellular pertussis vaccine.
The nursing staff has a team conference on acquired immunodeficiency syndrome (AIDS) and discusses the routes of transmission of the human immunodeficiency virus (HIV). The discussion reveals that there is no risk of exposure to HIV when an individual: 1 Has intercourse with just the spouse 2 Makes a donation of a pint of whole blood 3 Uses a condom each time there is sexual intercourse 4 Limits sexual contact to those without HIV antibodies
2 Makes a donation of a pint of whole blood Equipment used in blood donation is disposable; the donor does not come into contact with anyone else's blood. The risk depends on the spouse's previous behavior. Although condoms do offer protection, they are subject to failure because of condom rupture or improper use; risks of infection are present with any sexual contact. An individual may be infected before testing positive for the antibodies; the individual can still transmit the virus. Test-Taking Tip: Identifying content and what is being asked about that content is critical to your choosing the correct response. Be alert for words in the stem of the item that are the same or similar in nature to those in one or two of the options. Example: If the item relates to and identifies stroke rehabilitation as its focus and only one of the options contains the word stroke in relation to rehabilitation, you are safe in identifying this choice as the correct response.
A client who is scheduled for a modified radical mastectomy decides to have family members donate blood in the event it is needed. The client has type A negative blood. Blood can be used from relatives whose blood is: 1 Type O positive 2 Type AB positive 3 Type A or O negative 4 Type A or AB negative
3 Type A or O negative Both A and O negative blood are compatible with the client's blood. A negative is the same as the client's blood type and preferred; in an emergency, type O negative blood also may be given. Although type O blood may be used, it will have to be Rh negative; Rh positive blood is incompatible with the client's blood and will cause hemolysis. Type AB positive blood is incompatible with the client's blood and will cause hemolysis. Type A negative blood is compatible with the client's blood, but type AB negative is incompatible and will cause hemolysis.
The parents of a 6-week-old infant who was born without an immune system ask the nurse why their baby is still so healthy. What is the best response by the nurse? 1 Exposure to pathogens during this time can be limited. 2 Some antibodies are produced by the infant's colonic bacteria. 3 Bottle feeding with soy formula has boosted the immune system. 4 Antibodies are passively received from the mother through the placenta and breast milk.
4 Antibodies are passively received from the mother through the placenta and breast milk. Antibodies received in utero through the placenta and by the newborn in the mother's breast milk provide the infant with immunity against most viral, bacterial, and fungal infections during the first several weeks after birth. Then, as the titer of maternal antibodies drops and is not replaced by the infant's own antibodies, prolonged and repeated infections may occur. Limiting exposure to pathogens during this time is not enough to prevent infections in an immunocompromised infant. Bacteria do not produce antibodies. Bottle feeding with soy formula has not been proved to boost immunity in infants.
The parent of a child who has received all of the primary immunizations asks the nurse which ones the child should receive before starting kindergarten. The nurse tells the parent that her child should receive: 1 IPV, HepB, Td 2 DTaP, HepB, Td 3 MMR, DTaP, Hib 4 DTaP, IPV, MMR
4 DTaP, IPV, MMR Scheduled immunizations for preschool children include diphtheria, tetanus, and pertussis (DTaP), the inactivated polio vaccine (IPV), and measles, mumps, and rubella (MMR) at 4 to 6 years (usually required by law). Hepatitis immunization is given in three doses between birth and 9 months; the tetanus/diphtheria vaccine is given at 7 to 10 years of age, with subsequent doses based on the age when the vaccine was first received. Hepatitis B immunization is not required once immunity is established; administration of a subsequent dose of tetanus/diphtheria vaccine is based on the age when the first dose is received. The Haemophilus influenzae type B (Hib) vaccine is given at 12 to 15 months.
A nurse is reviewing the immunization schedule of an 5-month-old infant. What immunizations does the nurse expect the infant to have already received? 1 Rubella, polio, tuberculosis, rotavirus, varicella, pertussis 2 Pertussis, tetanus, polio, rotavirus, pneumococcal, measles 3 Measles, mumps, rubella, rotavirus, pertussis, tuberculosi 4 Rotavirus, DTaP, Haemophilus influenzae, polio, pneumococcal
4 Rotavirus, DTaP, Haemophilus influenzae, polio, pneumococcal According to the 2013 Centers for Disease Control and Prevention immunization schedule, a 5-month-old infant should have received the following vaccines: rotavirus, DTaP (diphtheria, tetanus, and pertussis), Hib (Haemophilus influenzae ), IPV (polio), and PCV (pneumococcal). Measles vaccine is not usually administered until the infant is at least 12 months old. The rubella vaccine is not usually administered until an infant is at least 12 months of age. There is no tuberculosis vaccine. Administration of the varicella vaccine is not recommended until an infant has reached 12 months of age.
A nurse is caring for a first-grader receiving prednisone (Meticorten). What outcome does the nurse expect with adrenocorticosteroid therapy? 1 Accelerated wound healing 2 Development of hyperkalemia 3 Increased antibody production 4 Suppressed inflammatory process
4 Suppressed inflammatory process Because of the suppression of the inflammatory process, the nurse must be alert to the subtle symptoms of infection, such as changes in appetite, sleep patterns, and behavior. Adrenocorticosteroid therapy delays, not accelerates, wound healing. Adrenocorticosteroid therapy may cause hypokalemia, not hyperkalemia, because of the accompanying retention of sodium and fluid. Adrenocorticosteroid therapy decreases, not increases, the production of antibodies. Test-Taking Tip: Because few things in life are absolute without exceptions, avoid selecting answers that include words such as always, never, all, every, and none. Answers containing these key words are rarely correct.
A nurse questions the parents of a child with chickenpox about relatives or friends who are undergoing specific prolonged medication therapy. What type of medication will put a person at risk if he or she is exposed to the varicella virus? 1 Anticonvulsant 2 Antihypertensive 3 Topical antibiotic 4 Systemic corticosteroid
4 Systemic corticosteroid Individuals taking steroids have reduced resistance to infection and may become fatally ill if exposed to the varicella virus. Anticonvulsants and antihypertensives do not reduce body resistance; therefore susceptibility is not increased. Topical antibiotics do not affect body resistance because their effect is not systemic.
A nurse is assessing clients who are to be given the smallpox vaccination. Which client should the nurse remove from the immunization line for medical counseling? 1 20-year-old healthy woman 2 45-year-old woman with breast cancer 3 50-year-old man with diabetes mellitus 4 75-year-old man who has Parkinson disease
The smallpox vaccine should not be given to individuals who may be immunocompromised as a result of therapy for cancer. There is no contraindication to giving the smallpox vaccination to a healthy woman, a client with diabetes mellitus, or a client with Parkinson disease. STUDY TIP: Enhance your organizational skills by developing a checklist and creating ways to improve your ability to retain information, such as using index cards with essential data, which are easy to carry and review whenever you have a spare moment.